Dubost J J, Sauvezie B
Unité d'Immunologie clinique, Hôpital Gabriel-Montpied, Clermont-Ferrand.
Rev Rhum Mal Osteoartic. 1992 Sep;59(6 Pt 2):37S-42S.
Rheumatoid arthritis (RA) and polymyalgia rheumatica (PMR) are the most common rheumatologic diseases encountered in older patients. However, other disorders including spondylarthropathy and a variety of connective tissue diseases also occur in the elderly. PMR and the RS3PE syndrome seem to occur only in the elderly, although their symptoms may be difficult to differentiate from those of other conditions. Late-onset RA and, above all, late-onset spondylarthritis may have unusual presentations responsible for diagnostic mistakes. Pitting edema is typical of RS3PE syndrome but may also occur in other rheumatic diseases. This symptom seems to be associated with advanced age rather than with a specific cause. Because of these many unusual features, rheumatologic diseases in the elderly are often difficult to diagnose and to differentiate from a variety of other rheumatologic or nonrheumatologic conditions.
类风湿关节炎(RA)和风湿性多肌痛(PMR)是老年患者中最常见的风湿性疾病。然而,包括脊柱关节病和各种结缔组织病在内的其他疾病在老年人中也会出现。PMR和RS3PE综合征似乎仅发生于老年人,尽管其症状可能难以与其他病症的症状相区分。迟发性RA,尤其是迟发性脊柱关节炎,可能有不寻常的表现,容易导致诊断错误。凹陷性水肿是RS3PE综合征的典型症状,但也可能出现在其他风湿性疾病中。这种症状似乎与高龄有关,而非特定病因。由于存在这些诸多不寻常的特征,老年风湿性疾病往往难以诊断,也难以与各种其他风湿性或非风湿性病症相鉴别。